Theatre Syllabus Contract/Consent & Release Form

Return this sheet by the next class day for your first grade.

I, (print student name) ___________________________________ have read the Theatre

Syllabus and understand the class requirements.

Student Signature _______________________________ Class Period_____________

Parent Signature _______________________________ Date__________________________

Print Parent Name_____________________________________________________________

Parent Email (print clearly)_______________________________________________________

Parent Phone(Cell)_______________________(Alt)__________________________________

CONSENT FORM AND RELEASE

This form applies to students being photographed, video taped, audio taped and interviewed in
connection with School/ Theatre activities and events.
Check the applicable:
________ No, I do not grant permission to use my child’s likeness in photographs, video
recordings or electronic images in any and all of its publications, including website entries for
purposes of publicizing the organization's programs or for any other lawful purpose.
________ Yes, I grant permission to use my child's likeness in photographs, video recordings
or electronic images in any and all of its publications, including website entries for purposes of
publicizing the organization's programs or for any other lawful purpose.

By signing below, I consent to the school’s use of my child's photograph, likeness, or voice on
the Internet, an educational CD, or any other electronic/digital media. As the child's parent or
legal guardian, I agree to release and hold harmless the school and the Spring Branch
Independent School District, its members, officers, volunteers and employees from and against
any and all claims that shall arise out of or by reason of, or be caused by the use of my child's
creative work(s), photograph, likeness, or voice on television, radio, motion pictures, the print
medium, the Internet or any other electronic/digital medium. It is further understood and I do
agree that no monies or other consideration in any form, including reimbursement for any
expenses incurred by me or my child, will become due to me or my child at any time because of
my child's participation in any of the above activities or the above-described use of my child's
creative work(s), photograph, likeness, or voice.

Guardian
Signature______________________________________Date____________________